Knowledge and Skills for Management of Sexually Transmitted Infections by Rural Medical Practitioners in Bangladesh

Abstract

Sexually transmitted infection (STI) management is considered rudimentary among rural medical practitioners (RMPs) in Bangladesh. We sought to understand the level of knowledge and skills in

STI management and to assess the impact of a two-day training orientation among RMPs in Tan- gail district. Data were collected through a baseline survey of 225 practicing RMPs in the study

area and a three-month follow-up survey of 99 RMPs who participated in a two-day STI/HIV ori- entation training. The level of formal training among RMPs ranged from none (22.7%), to para- medical training (14.7%) and local medical assistant training (62.6%). The baseline survey re- vealed a low level of STI/HIV knowledge and misconceptions about the transmission of STI/HIV

among RMPs. RMPs mostly prescribed first line antibiotics for treatment of common reproductive tract infections (RTIs) including STIs, but they rarely prescribed the correct dosages according to the national RTI/STI management guidelines. Only 3% of RMPs were able to correctly answer all four HIV transmission (unprotected sexual intercourse, blood transfusion, needle sharing and

mother to child transmission) questions at baseline, while 94.9% of RMPs answered all four cor- rectly at three months following the training (p = 0.001). Only 10% of RMPs reported suggesting

the recommended drug (azithromycin) and only 2% mentioned about the recommended dosage

(2 gm single dose) for the treatment of urethritis/cervicitis; compared to 49.5% suggested azith- romycin at follow-up with 39.4% mentioned the recommended 2 gm single dose (p = 0.001). Our

study found low level of knowledge and poor practices related RTI/STI management among RMPs. Short orientation training and education intervention shown promise to increase knowledge and management skills for RTIs/STIs.